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What is the original gold standard drug of choice?
Chloroquine.
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Which 2 drugs is malarone made of?
Atovaquone and proguanil
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How do you dose malarone?
once daily.
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How often do you take Mefloquine?
once weekly.
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What are contraindications to Mefloquine?
Hx of (depression, anxiety, psychosis, schizophrenia) seizures, cardiac conduction abnormalities
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What can mefloquine do to the heart?
Prolong the QT interval.
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Which drug can cause hemolytic anemia in those w/ G6PD?
Primaquine.
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What is the brand name of mefloquine?
Lariam.
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What's the most effective mosquito repellent?
DEET.
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What is the insecticide you can use on cloting and sleeping bags?
Permethrin.
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What are the 3 drugs of choice for prevention of malaria, and the 1 alternative?
- CHOICE: Malarone, Mefloquine, Doxycycline
- Alternative: Primaquine.
*Use chloroquine phosphate for chloroquine-sensitive areas
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What drug is made of wormwood?
Artemisinin.
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What are the 2 synthetic derivatives of Artemisin?
Artesunate and Artemether
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How many clinical cases of malaria are there per year in the world?
350-500 million
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What is the most common Plasmodium species?
P. falciparum, which is also the most dangerous.
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How does Plasmodium falciparum block blood vessels?
By forming RBC membrane knobs which causes RBCs to clump together--> hypoxia
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What is the 2nd most common form of malaria?
P. vivax
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Which 2 malaria strains do not have a carrier stage?
P. falciparum and P.malariae
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Which is the only strain of malaria that can affect RBCs of all ages?
P. falciparum
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Sickle cell disease and trait allow protection to which malaria species?
Only P. falciparum
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What are 2 potentital serious complications of malaria?
Blackwater fever & cerebral malaria.
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What are the 3 classic stages of the febrile attacks of malaria.
- 1) "Cold stage" 15min-1 hr before fever
- 2) "Hot stage"- 39-41oC (w/ anorexia, arthralgia)
- 3) "Sweating stage" within 2-6 hrs. no more fever, sleepy
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Blackwater fever has which 2 characteristic manifestations?
jaundice & hemoglobinuria (dark urine)
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When should chemoprophylaxis start and end?
Start 2 weeks before departure, until 4 weeks after return
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How do you diagnosis malaria?
- Gold std: blood smear
- Others: ELISA, PCR
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Which is the only drug that stops the malaria in the liver?
Primaquine
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When is it best to get a blood smear for P. falciparum? For the others?
- P. falciparum: right after fever peak.
- Others: any time.
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What are the thick and thin blood smears done to detect?
- Thick: presence of Plasmodium
- Thin: the species.
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What % parasitemia is a medical emergency?
5%
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